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J. Phys. Ther. Sci.

29: 1649–1652, 2017

The Journal of Physical Therapy Science

Original Article

A newly developed floor chair placed on


an office chair reduces lumbar muscle fatigue
by cyclically changing its lumbar supporting shape

Tadamitsu Matsuda, RPT, PhD1)*, Takayuki Koyama, RPT, PhD2),


Yasushi Kurihara, RPT, PhD1), Miki Tagami, RPT, PhD1),
Yasuaki Kusumoto, RPT, PhD3), Osamu Nitta, RPT, PhD4)
1) Department of Physical Therapy, Faculty of Social Work Studies, Josai International University:
1 Gumyo, Togane, Chiba 283-8555, Japan
2) Department of Physical Education, Nihon University, Japan
3) Department of Physical Therapy, Faculty of Health Sciences, Tokyo University of Technology, Japan
4) Graduate School of Human Health Science, Tokyo Metropolitan University, Japan

Abstract. [Purpose] This study investigated lumbar muscle fatigue before and after maintaining a seated posi-
tion for one hour, lumbar and pelvic inclination angle change, in subjects with and without active lumber support.
[Subjects and Methods] Fourteen healthy subjects randomized into two groups sat on a floor chair, placed on an
office chair, that cyclically changed its lumbar supporting shape to provide active lumbar support (ALS) or no ALS
for one hour. Before and after, we measured the frequency of muscle waveforms of the trunk extensor muscles when
the subjects lifted an object weighing 10% of their body weight, using both hands while seated. In addition, ROMt
(Range of motion test) of trunk rotation, degree of fatigue and muscle stiffness were analyzed. [Results] Muscle fre-
quency while lifting the weight decreased significantly without ALS compared to with ALS. Mean muscle stiffness
increased, ROMt decreased in desk work task significantly without ALS compared to with ALS. [Conclusion] These
results suggest that the lumbar muscles became fatigued, because low frequencies, increased muscle stiffness, and
decreased ROMt without ALS. We suggest lumbar muscle fatigue was maintained low for subjects seated in a chair
with ALS.
Key words: Muscle fatigue, Active lumbar support, Low back pain
(This article was submitted May 30, 2017, and was accepted Jun. 15, 2017)

INTRODUCTION
Recent studies have shown an association between prolonged and low back pain (LBP)1, 2). Occupational LBP has become
a major problem in industrial health3). The major causes of LBP include handling heavy objects, standing up for long periods
of time, and performing tasks while seated, with further investigation of the latter finding that fatigue in the lumbar muscles
caused by maintaining a seated position for a long period of time can lead to LBP4, 5). One representative bad sitting posture is
a head forward position6), involving bending of the waist. In this position, the head is located more anteriorly than in control
subjects, leading to acute LBP7). An increased bending posture increases the shearing force on the lumbar vertebrae and the
compressive force on the vertebral duct, reducing tissue tolerance8). It has been estimated that 50–80% of the population
experiences LBP, which negatively affects daily life and task perfbrmance9). Chronic low back pain (CLBP), defined as LBP
sustained for >12 weeks10), has been associated with various motor control problems, including damage to postural adjust-
ment11) and delay in muscular response12).

*Corresponding author. Tadamitsu Matsuda (E-mail: tmatsuda@jiu.ac.jp)


©2017 The Society of Physical Therapy Science. Published by IPEC Inc.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives
(by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Table 1. Demographic characteristics of study subjects
ALS activated ALS not activated
(n=7) (n=7)
Age (years) 21.4 ± 0.8 21.4 ± 0.8
Height (cm) 167.1 ± 5.6 169.5 ± 10.9
Weight (kg) 54.7 ± 8.5 57.6 ± 9.9
All results are reported as mean ± standard deviation.

Table 2. Parameters measured before and after maintaining ALS activated


and ALS not activated for 1 hour
ALS not activated ALS activated
pre post pre post
FFD (cm) 0 0.4 ± 1.1 3.4 ± 4.7 2.6 ± 5.5
ROM[Rt] (°) 30.0 ± 9.6 27.1 ± 8.1 27.9 ± 4.9 27.9 ± 6.4
ROM[Lt] (°) 29.3 ± 9.3 24.3 ± 6.7* 27.1 ± 4.9 27.9 ± 5.7
Stiffness (Rt) 47.9 ± 8.4 54.5 ± 10.9* 53.4 ± 9.7 54.8 ± 11.6
Stiffness (Lt) 50.9 ± 10.0 61.5 ± 8.3* 53.0 ± 10.7 52.9 ± 12.5
VAS 2.5 ± 2.0 1.3 ± 0.9
All results are reported as mean ± standard deviation
*p<0.05. Rt: right; Lt: left

Lumbar support devices, which support the lordosis of the back side of the lumbar region, have been commercialized
and used frequently. Pelvic anteversion has been reported significantly higher in the presence than in the absence of lumbar
support13). General lumbar support can maintain lordotic lordosis and anteversion of the pelvis, resulting in a posture in the
sitting position close to the ideal physiological lordosis. However, even with general lumbar support, maintaining the same
posture for a long period of time may reduce tissue tolerance of the lumbar loading structure, accompanied by sustained stress
and increased tissue viscosity. Although the application of sustained stress to viscoelastic tissue leads to a creep phenomenon
that causes tissue deformation, a creep phenomenon, even in the lumbar region, has also been observed after sustaining a
bending posture for 20 minutes14). Tissue tolerance may decrease while viscous friction increases after maintaining the same
posture for a long time, and may also occur after maintaining an intermediate waist posture. Furthermore, deformation caused
by the creep phenomenon has been associated with microscopic damage to the tissue14). Moving one’s waist while in a sitting
position may prevent the deleterious effects on posture of maintaining the same position for a long period of time.
We have therefore constructed a prototype active lumbar support (ALS) chair with an automatic shape-changing function
that automatically moves the waist during sustained sitting in a poor desk work environment and everyday life. Using ALS
may reduce fatigue of back muscles and lumbar soft tissue. This study investigated the effects of ALS on lumbar muscle
fatigue by measuring the latter before and after maintaining a seated position for a long period of time with and without
transitive pelvic angle changes.

SUBJECTS AND METHODS


The study subjects comprised 14 healthy individuals, seven men and seven women, of mean age 21 years, with no current
back pain. They were randomly separated into two groups (Table 1). Written informed consent was obtained from each
participant before the study. The study protocol was approved by the Tokyo Metropolitan University of Health Sciences
Ethical Review Board (Authorization Number 16042). All authors declare they have no conflicts of interest.
We developed a seat with an ALS shape-changing function designed to suppress lumbar pain fatigue by transitively
changing the pelvic angle when a person performs seated tasks for long periods of time. The ALS regularly pushes the lower
back anteriorly to prevent prolonged sitting in the same posture. The subjects were required to maintain a desk work seated
position for one hour. Subjects in the control group sat on the device without ALS activated; whereas ALS group subjects
sat on the device with ALS activated. The device was a newly developed small floor chair, placed on an office chair, which
could have ALS switched to on or off. (Rinnza Auto, Labonetz Inc. Japan; Fig. 1). The ALS included automatic air pressure
and back support (Fig. 2) and was designed to rise in two stages, with each cycle lasting 34 sec.
Electrodes for surface electromyography were attached to the right and left sides of each subject, from 3 cm L3–4, and the
frequency bandwidth was set at 1,000 Hz. Before and after sitting for one hour, the subjects had to use both hands to lift an
object, weighing 10% of their body weight, while seated.
Bilateral erector spinae muscle activity was recorded by surface electromyography (DKH Inc. Japan) after filtering. Fre-
quency analyses were performed of muscle waveforms of the trunk extensor muscle, and the mean power frequency (MPF)
and median values (MDF) were calculated.

J. Phys. Ther. Sci. Vol. 29, No. 9, 2017 1650


Fig. 1. Front and side views of the developed chair with active
lumbar support
Right figure: Experiment environment

Fig. 2. Schematic diagrams showing active back rest, with each


cycle requiring 34 sec
Before and after sitting for one hour, trunk rotation a: off phase: flow of air away from the subject through the back rest
in the sitting position was assessed by performing active (pelvic neutral position)
b: stage 1: flow of air towards the subject through the back rest
range of motion tests (ROMt) using a goniometer. Other
(pelvic forward tilt and lumber lordosis)
parameters measured before and after sitting for one hour
c: stage 2: flow of air towards the subject through the back rest
included finger-floor distance (FFD), muscle stiffness us-
(more pelvic forward tilt and lumber lordosis)
ing a durometer (PEK-1, ImoNET Inc., Japan) and degree
The air bag inserted in the lumbar support on the back expands in
of fatigue using a visual analog scale (VAS) ranging from two stages (upper row), pushing the waist forward within one cycle
0 (no fatigue) to 10 (highest fatigue) points. (34 seconds). The lower row shows the timing of inflation of the air
Measurements obtained before and after sitting for one bag using an electric motor (DC 12.8 V, 1.8 A).
hour were compared statistically using Wilcoxon’s rank-
sum tests. All statistical analyses were performed using the
SPSS statistical package for Windows, version 21.0, with p
values<0.05 considered statistically significant.

RESULTS
MPF and MDF decreased before and after sitting for one hour while performing desk work tasks without ALS compared
to with ALS (Table 3). MDF (left side) while lifting a weight decreased significantly before and after being seated for 1 hour
without ALS, but no change with ALS. Mean muscle stiffness increased, ROMt decreased in desk work task significantly
without ALS compared to with ALS (Table 2).

DISCUSSION
The present results suggest that the lumbar muscles became fatigued without ALS, reducing frequencies, increasing
muscle stiffness, and decreasing ROMt. Muscle stiffness was lower after sitting on a chair with ALS, suggesting a reduction
in extendibility of the lumbar muscles. The ALS prototype was designed to generate sustained passive movement of the
waist and pelvic region while sitting. A previous study assessing whether the waist actually moves while being seated in the
ALS prototype found that inflating to the second stage of ALS resulted in an average anterior pelvic inclination angle of 1°
and that the average forward motion of the waist at the third lumbar level was 8 mm (p<0.05)15). Thus, tissue stiffness in the
lumbar region was regarded as associated with reduced ROMt, due to increased muscle fatigue in the normal seated position
and increased muscle stiffness. Chronic pain has been found to increase muscle fatigue16). Muscle fatigue generated by
maintaining muscular contractions while being in the same fixed sitting posture has been found to cause chronic lumbar pain.

Table 3. Muscle frequencies before and after maintaining normal and dynamic
sitting positions for 1 hour
ALS not activated ALS activated
pre post pre post
MDF Rt 81.0 ± 14.2 65.6 ± 19.7 77.3 ± 17.8 91.6 ± 19.7
Lt 78.5 ± 10.3 65.9 ± 16.6* 79.4 ± 18.0 89.6 ± 23.1
MPF Rt 101.1 ± 16.2 96.4 ± 17.2 102.7 ± 21.4 112.7 ± 23.0
Lt 92.4 ± 11.1 92.5 ± 17.8 101.6 ± 19.3 110.66 ± 21.9
All reports are reported as mean ± standard deviation.
*p<0.05
Rt: right; Lt: left

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Although the differences were not statistically significant, even in VAS, sitting on the ALS prototype, even for 1 hour, was
not associated with fatigue. These findings indicate that the ALS could maintain a sitting position with a comfortable posture.
Electromyogram frequency is dependent on type of muscle fiber, with Types I and II being in the low and high frequency
regions, respectively. Suppression of activity due to fatigue of Type II fibers result in MPF and MDF gradually becoming
lower. When MDF of the lumbar muscle was compared with MPF while lifting 10% of body weight for about 1 hour in the
sitting position, we found that frequency was lowered only on the left side (Table 3). This may have been due to muscle
fatigue in the normal seated position in the absence of ALS, resulting in the muscles having a low frequency immediately
after lifting the weight. Despite the non-occurrence of lumbar muscle fatigue when performing ALS after performing the
Sorensen test15), ALS was regarded as less likely to cause lumbar muscle fatigue. However, because there was a significant
difference only in the left hip, further study is considered necessary. The ROMs of flexion and extension have been reported
significantly increased following lumbar exercise17), suggesting that mild exercise of the lumbar region can expand ROM.
Maintaining a fixed posture, whether standing or sitting, for a long period of time is a cause of LBP1, 2). The results of the
present study suggest that moving the lumbar area, including the pelvis, through automatic air injection and removal while
sitting, can prevent or reduce fatigue in the lumbar muscles. The major limitation of this study was that all subjects were in
the same age group (mean age, 21 years). Therefore, these findings require verification in other age groups. Additional studies
are also required to analyze the relationships of ALS degree of expansion and cycle time with tissue tolerance and muscle
fatigue, thereby optimizing ALS parameters.

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